Health Assessments (HAs)

Bellin Health will be conducting the City’s Health Assessments (HA) beginning in March 2021. By completing the HA and requirements, eligible participating employees will earn points to be used to reduce employee health insurance premium contributions, earn Personal Benefit Account (PBA) dollars, and other incentives.

For Police Officers and Fire Fighters - completion of the HA and requirements by employee and spouse, if applicable, will provide PBA dollars and a reduced employee health insurance premium contribution as low as 12.5%. Health|1265 participants can reduce their premium to 11.5%.

Deadline to complete HA and requirements is September 24, 2021.

HA Requirements & Incentives

*If Employee or Spouse is over age 40 by January 1, 2020, the MD Sign Off Form and the HA must be completed. Spouses may complete their HA through their own employer, but must submit the Spouse HA Sign Off Form.
  Single Coverage
 Family Coverage
Under Age 40
 Employee completion of HA. Employee and Spouse (if applicable) completion of HA.*
Over Age 40
 Employee completion of HA and MD Sign Off Form. Employee and Spouse (if applicable) completion of HA and MD Sign Off Form.*
PBA Dollars (HA and MD Sign Off)
 $100 earned upon completion of all requirements. $200 earned upon completion of all requirements.
PBA Dollars (Dental)
 $50 per dental cleaning (max of 2) for employee. $50 per dental cleaning (max of 2) for employee.
$50 per dental cleaning (max of 2) for Spouse/covered family member.

Important Forms

  1. 2021 Health Assessment Informational Packet (PDF)
  2. Dental Cleaning Form (PDF)
  1. MD Sign Off Form (PDF)
  2. Spouse HA Sign Off Form (PDF)